Gingival overgrowth in subjects under immunosuppressive regimens based on cyclosporine, tacrolimus, or sirolimus

Cota, Luís Otávio Miranda; Aquino, Davi Romeiro; Franco, Gilson César Nobre; Cortelli, José Roberto; Cortelli, Sheila Cavalca; Costa, Fernando Oliveira

doi:10.1111/j.1600-051x.2010.01601.x

Cited by 44 publications

(49 citation statements)

References 35 publications

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“…Animal research indicated a higher proportion of Pg in the test sites of CsA‐medicated beagle dogs . A recent study showed that GO subjects presented a higher frequency of Tf in the salivary samples of immunosuppressed patients under the administration of CsA, tacrolimus, or sirolimus . The results of the present study demonstrated a relationship between the prevalence of red complex and CsA‐induced GO.…”

Section: Discussionsupporting

confidence: 70%

Association of CD14‐260 polymorphisms, red‐complex periodontopathogens and gingival crevicular fluid cytokine levels with cyclosporine A‐induced gingival overgrowth in renal transplant patients

Gong

Cao

et al. 2012

J of Periodontal Research

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Backgroud and Objective Genetic factors may influence the colonization of pathogenic bacteria, therefore increasing the risk for the initiation and development of periodontal disease. The present study was carried out to investigate the association of CD14-260 polymorphisms, subgingival microbiota, and gingival crevicular fluid (GCF) cytokine levels with cyclosporine A (CsA)-induced gingival overgrowth (GO) in renal transplant patients. Material and Methods 204 patients were dichotomized into two groups: 124 with GO and 80 without GO. The CD14-260 polymorphisms were measured using an allele-specific PCR method. The levels of periodontal pathogens were determined by real-time PCR of subgingival samples. GCF levels of IL-1β and sCD14 were detected by ELISA. Results The frequency of CD14-260 genotype CT + TT was found to be similar in both groups. Patients with GO presented increased prevalence of Pg, Td, and Tf (red complex) and significantly higher levels of IL-1β than those without GO. GO patients carrying CT+TT genotypes were found to have higher frequencies of Pg, Td, and Tf than those carrying CC genotype. Furthermore, in the presence of red complex, CT+TT genotypes were associated with higher IL-1β levels and severe GO. Multiple logistic regression analysis demonstrated that the severity of GO is not dependent on age, gender and pharmacological variables, being only associated with CD14-260 genotype and red complex periodontopathogens. Conclusions No association between CD14-260 polymorphisms and the prevalence of GO was revealed in renal transplant patients administered CsA. However, CD14-260 CT+TT genotypes are associated with the prevalence of red complex periodontopathogens in GO patients, and may thus play some role in the development of severe CsA-induced GO.

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Section: Discussionsupporting

confidence: 70%

Association of CD14‐260 polymorphisms, red‐complex periodontopathogens and gingival crevicular fluid cytokine levels with cyclosporine A‐induced gingival overgrowth in renal transplant patients

Gong

Cao

et al. 2012

J of Periodontal Research

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“…The drug categories and representative drugs including the newer drugs are listed in Table 1. [1][2][3][4][5] Ellis et al 6) discussed the overall prevalence of gingival overgrowth related to chronic medication with CCBs, addressing it is considerably lower than finding from previous studies. Therefore, the expression of this effect needs cofactors such as the presence of gingival inflammation or concomitant medications inducing gingival overgrowth.…”

Section: Introductionmentioning

confidence: 51%

Drug-induced Gingival Overgrowth Related to Sirolimus and Felodipine

Park¹,

Lee²,

Kim³

et al. 2017

Journal of Oral Medicine and Pain

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Drug-induced gingival overgrowth (DIGO) is an adverse drug reaction mainly described with three types of commonly prescribed drugs, namely, calcium channel blockers (CCBs) (nifedipine, diltiazem, and verapamil), anti-convulsants (phenytoin), and immunosuppressive agents (cyclosporine). Numerous reports have associated gingival overgrowth with the newer generation of immunosuppressive agents (tacrolimus, sirolimus, and everolimus), and CCBs (amlodipine, felodipine, nicardipine, and manidipine). Especially, patients concomitantly medicated with an immunosuppressive agent and CCB have a higher DIGO chance. Dentists need to be aware of drugs that induce gingival overgrowth, the possibility of DIGO, and risk factors, and also prevent the progression of DIGO by early detection of DIGO, consultation about the drug change, and the maintenance of strict dental hygiene regimes.

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“…It is believed that CsA affects the fibroblasts, increasing their proliferation, as well as other extracellular factors. This suggests a significant role of dental plaque, in which CsA can accumulate (13,23,24 ). So as previous publications had showed, it is possible to place dental implants in patients with long-term immunosuppressive therapy following organ transplants, but this subject needs further and more extensive research.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Implants in Kidney Transplant Patient Undergoing Immunosuppressive Therapy: Case Report

Cengiz¹,

Cengiz²,

Atalay³

et al. 2018

J Int Dent Sci

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Since the beginning of oral implant surgery, it has been recommended to exclude certain patients with systemic health problems from implant therapy. Although many studies have been done about the effect of systemic disease like diabetes and osteoporosis on implant success but there wasn't enough data about the effect of organ transplantation and immunosupresive therapy on implant success in the literature. As the success rate of organ transplantations increased, the number of patients on immunosupressive treatment increased. It has been reported in the literature that organ transplant patients undergoing immunosuppressive therapy may experience periodontal side-effects such as gingival overgrowth and implant failure. In our case 10 year of implant success was examined on the patient who are exposed to kidney transplantation 8 years ago and who takes cortisone and immunosupressive.

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Gingival overgrowth in subjects under immunosuppressive regimens based on cyclosporine, tacrolimus, or sirolimus

Abstract: Pharmacological and periodontal variables were associated with GO in different immunosuppressive regimens. Integration between the medical and the dental team may be an important approach in the post-transplant maintenance routine.

Cited by 44 publications

References 35 publications

Association of CD14‐260 polymorphisms, red‐complex periodontopathogens and gingival crevicular fluid cytokine levels with cyclosporine A‐induced gingival overgrowth in renal transplant patients

Association of CD14‐260 polymorphisms, red‐complex periodontopathogens and gingival crevicular fluid cytokine levels with cyclosporine A‐induced gingival overgrowth in renal transplant patients

Drug-induced Gingival Overgrowth Related to Sirolimus and Felodipine

Outcome of Implants in Kidney Transplant Patient Undergoing Immunosuppressive Therapy: Case Report

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